甲状腺功能正常的2型糖尿病患者合并DKD的影响因素分析OA

Objective To explore the influencing factors of diabetic kidney disease(DKD)in euthyroid patients with type 2 diabetes mellitus(T2DM).Methods A total of 1 061 T2DM patients hospitalized in the endocrinology department of this hospital from January 2017 to December 2022 were selected as the study subjects.They were divided into the DKD group and the non-DKD(NDKD)group according to whether they had concomitant DKD.Clinical data and metabolic indicators of patients in the two groups were compared,and logistic regression analysis was performed to explore the influencing factors of T2DM complicated with DKD.Further,DKD patients were divided into 3 subgroups according to the urinary albumin to creatinine ratio(UACR)levels,and differences in metabolic indicators among different DKD subgroups were compared.Re-sults Compared with the NDKD group,the DKD group had a higher proportion of females,older age,and higher levels of alkaline phosphatase(ALP),serum uric acid(UA),blood urea nitrogen(BUN),cystatin C(CysC),complement C1q(C1q),and homocysteine(HCY),P<0.05,and lower levels of vitamin D(VitD),total bilirubin(TBIL),free T3(FT3),total T3(TT3),and alanine aminotransferase(ALT).Univariate and multivariate logistic regression analyses showed that VitD,TBIL,ALP,CysC,and FT3 were independent in-fluencing factors for T2DM complicated with DKD(P<0.05).Analysis of variance was performed among the 3 DKD subgroups,and the results showed that the levels of TBIL,CysC and FT3 presented a certain changing trend with the elevation of UACR grading(TBIL and FT3 decreased,while CysC increased,P<0.05).Con-clusion Elevated FT3,VitD and TBIL levels are independent protective factors for T2DM complicated with DKD,and elevated ALP and CysC levels are independent risk factors.Among them,FT3,TBIL and CysC show significant differences among different DKD groups,which indicates that the three have a certain associa-tion with different stages of DKD.